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Modelling study to estimate the health burden of foodborne diseases: cases, general practice consultations and hospitalisations in the UK, 2009.

ABSTRACT: OBJECTIVE:To generate estimates of the burden of UK-acquired foodborne disease accounting for uncertainty. DESIGN:A modelling study combining data from national public health surveillance systems for laboratory-confirmed infectious intestinal disease (IID) and outbreaks of foodborne disease and 2 prospective, population-based studies of IID in the community. The underlying data sets covered the time period 1993-2008. We used Monte Carlo simulation and a Bayesian approach, using a systematic review to generate Bayesian priors. We calculated point estimates with 95% credible intervals (CrI). SETTING:UK, 2009. OUTCOME MEASURES:Pathogen-specific estimates of the number of cases, general practice (GP) consultations and hospitalisations for foodborne disease in the UK in 2009. RESULTS:Bayesian approaches gave slightly more conservative estimates of overall health burden (?511?000 cases vs 566?000 cases). Campylobacter is the most common foodborne pathogen, causing 280?400 (95% CrI 182?503-435?693) food-related cases and 38?860 (95% CrI 27?160-55?610) GP consultations annually. Despite this, there are only around 562 (95% CrI 189-1330) food-related hospital admissions due to Campylobacter, reflecting relatively low disease severity. Salmonella causes the largest number of hospitalisations, an estimated 2490 admissions (95% CrI 607-9631), closely followed by Escherichia coli O157 with 2233 admissions (95% CrI 170-32?159). Other common causes of foodborne disease include Clostridium perfringens, with an estimated 79?570 cases annually (95% CrI 30?700-211?298) and norovirus with 74?100 cases (95% CrI 61?150-89?660). Other viruses and protozoa ranked much lower as causes of foodborne disease. CONCLUSIONS:The 3 models yielded similar estimates of the burden of foodborne illness in the UK and show that continued reductions in Campylobacter, Salmonella, E. coli O157, C. perfringens and norovirus are needed to mitigate the impact of foodborne disease.

SUBMITTER: O'Brien SJ

PROVIDER: S-EPMC5030535 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Modelling study to estimate the health burden of foodborne diseases: cases, general practice consultations and hospitalisations in the UK, 2009.

O'Brien Sarah J SJ Larose Tricia L TL Adak Goutam K GK Evans Meirion R MR Tam Clarence C CC

BMJ open 20160913 9

<h4>Objective</h4>To generate estimates of the burden of UK-acquired foodborne disease accounting for uncertainty.<h4>Design</h4>A modelling study combining data from national public health surveillance systems for laboratory-confirmed infectious intestinal disease (IID) and outbreaks of foodborne disease and 2 prospective, population-based studies of IID in the community. The underlying data sets covered the time period 1993-2008. We used Monte Carlo simulation and a Bayesian approach, using a ...[more]

PMID: 27625054

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Project description:BackgroundTo follow the impact of the 2009 influenza pandemic in Denmark, influenza surveillance was extended with a system monitoring potentially influenza-associated hospitalisations.Methodology/principal findingsNational administrative data from 2004-2010 from the automatic reporting of all hospital visits and admissions in Denmark (population 5.5 million) were used. In-patient hospitalisations linked to ICD-10 codes for potentially influenza-associated conditions (influenza, viral and bacterial pneumonia, respiratory distress, and febrile convulsion) were aggregated by week and age groups; <5 years, 5-24 years, 25-64 years and ≥65 years. Weekly numbers of influenza-associated hospitalisations were plotted to follow the course of the pandemic. We calculated the total numbers of influenza-associated hospitalisations in each influenza season (week 30 to week 15, the following year). Risk ratios of being admitted with an influenza-associated condition in this season (2009/2010) compared to the previous five seasons (2004/2005-2008/2009) were calculated using binary regression. During the pandemic season, influenza-associated hospitalisations peaked in week 47, 2009. The total number of influenza-associated hospitalisations was 38,273 compared to the median of previous seasons of 35,662 (p = 0.28). The risk ratio of influenza-associated hospitalisations during the pandemic season compared to previous seasons was 1.63 (95%CI 1.49-1.78) for 5-24 year-olds and ranged between 0.98 and 1.08 for the other three age groups.ConclusionsThe 2009 pandemic influenza did not lead to an overall increase in the number of influenza-associated hospitalisations in Denmark in the 2009/2010 season and could be managed within existing hospital capacity. However, there was a disproportionally large impact on the age group 5-24 years. The influenza-associated hospitalisations during the 2009/2010 pandemic influenza season bore the signature features of historical pandemics: A skewed age-pattern and early out of season transmission.

Project description:The objectives of this study were to assess burnout in a sample of general practitioners (GPs), to determine factors associated with depersonalisation and to investigate its impact on doctors' consultations with patients.Cross-sectional, postal survey of GPs using the Maslach Burnout Inventory (MBI). Patient survey and tape-recording of consultations for a subsample of respondents stratified by their MBI scores, gender and duration of General Medical Council registration.UK general practice.GPs within NHS Essex.Scores on MBI subscales (depersonalisation, emotional exhaustion, personal accomplishment); scores on Doctors' Interpersonal Skills Questionnaire and patient-centredness scores attributed to tape-recorded consultations by independent observers.In the postal survey, 564/789 (71%) GPs completed the MBI. High levels of emotional exhaustion (261/564 doctors, 46%) and depersonalisation (237 doctors, 42%) and low levels of personal accomplishment (190 doctors, 34%) were reported. Depersonalisation scores were related to characteristics of the doctor and the practice. Male doctors reported significantly higher (p<0.001) depersonalisation than female doctors. Doctors registered with the General Medical Council under 20 years had significantly higher (p=0.005) depersonalisation scores than those registered for longer. Doctors in group practices had significantly higher (p=0.001) depersonalisation scores than single-handed practitioners. Thirty-eight doctors agreed to complete the patient survey (n=1876 patients) and audio-record consultations (n=760 consultations). Depersonalised doctors were significantly more likely (p=0.03) to consult with patients who reported seeing their 'usual doctor'. There were no significant associations between doctors' depersonalisation and their patient-rated interpersonal skills or observed patient-centredness.This is the largest number of doctors completing the MBI with the highest levels of depersonalisation reported. Despite experiencing substantial depersonalisation, doctors' feelings of burnout were not detected by patients or independent observers. Such levels of burnout are, however, worrying and imply a need for action by doctors themselves, their medical colleagues, professional bodies, healthcare organisations and the Department of Health.

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Modelling study to estimate the health burden of foodborne diseases: cases, general practice consultations and hospitalisations in the UK, 2009.

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Modelling study to estimate the health burden of foodborne diseases: cases, general practice consultations and hospitalisations in the UK, 2009.

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